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Scope of Practice

Scope of Practice Statute:

Board of Nursing Home

 

Please see sections of RSA 326-B, Nursing Practice Act.

  • Section: 326-B:14 Scope of Practice; Licensed Nursing Assistant.
  • Section: 326-B:13 Scope of Practice; Licensed Practical Nurse.
  • Section: 326-B:12 Scope of Practice; Registered Nurse.
  • Section: 326-B:11 Scope of Practice and Authority; Advanced Practice Registered Nurse.

Scope of Practice Advisories and Position Statements

National Guidelines for Nurse Delegations, jointly adopted by NCSBN and ANA

Position Statements and Advisories from the New Hampshire Board of Nursing

It is the expectation of the New Hampshire Board of Nursing that registered nurses working in specialties are familiar with the New Hampshire Nurse Practice Act, Rules and Regulations, policies of their respective facilities, and specialty-specific standards of practice. Activities performed under a nursing license must also comply with workplace policies. A workplace may prohibit a licensee from performing tasks that are allowed by the provisions of the Nurse Practice Act and Rules, but may not require a licensee to do more than the Practice Act and Rules allow.

Health care is constantly changing, and thus the practice of nurses and nursing assistants is changing. It would be impossible to develop a list of all procedures and interventions that are included in the scope of practice of nurses. Licensees are encouraged to utilize the Decision Tree algorithm in determining scope of practice for activities not included in these lists. If scope of practice remains unclear following use of the algorithm, licensees may submit a question to the board using the Clinical Practice Inquiry Process and Form. The board office also suggests licensees seek legal counsel for clarification of their particular scope of practice based on license, education and continuing competence.

Licensees should be mindful of the professional responsibility to maintain competency as specified in NUR 404.12, which states, "All licensees shall, through education and experience, maintain the ability to competently practice nursing or nursing related activities."

When adding nursing interventions and nursing related activities to role responsibilities, in addition to those interventions taught during the initial educational process, it is the recommendation of the Board that facilities consider implementation using the following guidelines as applicable:

  1. Describe the educational preparation and practice history of the nurses or nursing assistants authorized to perform the intervention(s) or activity(s)
  2. Define the intervention(s) or activity(s) and the procedures for implementing the intervention(s) or activity(s)
  3. Include a written plan for attaining and maintaining competency of the licensee
  4. Identify the names of those nurses or nursing assistants authorized to perform the interventions or activity(s), and
  5. Be reviewed and updated as needed, but at least yearly

The following links contain responses to specific frequently asked questions pertaining to RN, LPN and LNA scope of practice.

The Board of Nursing also recommends that licensees consult with appropriate regulatory/licensing boards to answer questions about specific procedures and/or practices that may be regulated by an entity other than the Board of Nursing, including but not limited to:

Board of Nursing Home